Non-motoring > Assisted Dying - Mayflies Miscellaneous
Thread Author: Bobby Replies: 5
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New Mon 2 Jan 23 10:06 
 Assisted Dying - Mayflies - Bobby
As mentioned in the TV thread, thought provoking program on end of life care and assisted dying.

I worked for 10 years in a hospice and missus is still a nurse in a hospice so I know all the wonderful care that they give. Especially pain control and making you as comfortable as possible to die with your family around you.

But watching the program last night there does seem to be a stage between “we can do no more treatment” And being ready for hospice care that could be excruciating painful and horrible for family around you.

Fingers crossed I have never had any serious illnesses to date but I am a very poor patient. Currently have the sore throat/ cough that’s doing the rounds and really feeling sorry for myself. I struggle to think how I would cope with chemo or any of the other treatments. In fact I struggle to think how I would cope to be given the news in the first place.

Fingers crossed I won’t ever need to. But I also know the realities.
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New Mon 2 Jan 23 10:45 
 Assisted Dying - Mayflies - zippy
Don't doctors administer pain relief knowing full well that it can dramatically shorten life?
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New Mon 2 Jan 23 15:53 
 Assisted Dying - Mayflies - Ted

I'm sure they do Zips. My ole mum, 82, had an Aortic Aneurism and summoned me to stay at hers one night as she wasn't feeling well. I called an ambulance, on the GPs instructions, in the morning and off we went to casualty.

She was given morphine and the doctor said the aneurism was dissecting and gave her 24 hrs. She was found a bed and we came back the following morning and sat with her. Only a mile trip on one road.

She was asleep all the time on a drip and we went home for a sandwich and to freshen up. As we walked in the front door the phone rang to say she had died. I'm convinced they upped the dose. I was happy with that, if they did.

Ted
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New Mon 2 Jan 23 16:16 
 Assisted Dying - Mayflies - zippy
>> Don't doctors administer pain relief knowing full well that it can dramatically shorten life?
>>
>> I'm sure they do Zips.

I posed my question above on the basis of what Miss Z tells me.

Obviously nothing illegal.

She had to make a long trip with a patient to major hospital centre that could care for the patient better - be nearer family etc.

The patient was terminal; they had a dreadful nasty cancer that made living intolerable and I know Miss Z was upset about it.

She was provided with enough morphine to kill an elephant and told to use it appropriately if the patient was in so much pain that pain relief was required.

She knew what the implications of giving the required doses meant and was thoroughly relieved that the supplied drips were enough.

The patient passed two days later.

A localish case - the first "Shipman" perhaps:

en.wikipedia.org/wiki/John_Bodkin_Adams

His trial introduced the concept of double effect; establishing the principle of double effect that if a doctor "gave treatment to a seriously ill patient with the aim of relieving pain or distress, as a result of which that person's life was inadvertently shortened, the doctor was not guilty of murder."
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New Mon 2 Jan 23 17:12 
 Assisted Dying - Mayflies - Bobby
My wife in the hospice says that it is very common occurrence for patients to die when their family have left the bedside after long visits, overnight stays etc.

Nothing to do with the nurses. More to do with the patients slipping away.
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New Wed 4 Jan 23 00:09 
 Assisted Dying - Mayflies - Lygonos
We often prescribe "Just-in-case" medications for patients who are terminal and who are at risk of "going off", eg. lung cancer who may bleed out, or patient's at risk of rapid deterioration.

These are then kept in a box in the patient's house with a Kardex to offer instruction to out-of-hours teams/paramedics who may attend.

The doses are to alleviate symptoms are certainly not "excessive".

In the first wave of Covid 2020 we were advised to provide the same for Care Home residents but with potentially much more frequent dosing (ie morphine/sedative injections hourly rather than 3-4 hourly): although most elderly patients with Covid at the time survived, a small but significant number suffered a very distressing and almost invariably fatal severe and rapidly deteriorating course, often dying within 24 hours of their first symptom.

The descriptive term for how these patients presented was with "air hunger" - remember patients with acute severe Covid are usually entirely compos mentis and feel that they are probably going to suffocate to death.

The treatment of severe distress trumps prolonging end-of-life every time.
Last edited by: Lygonos on Wed 4 Jan 23 at 00:11
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